In addition to each person's individual psychobiological core, cultural factors, which include beliefs and values, life experiences and habits, there are many other factors that can influence whether you're going to gain weight and/or if you're going to lose weight successfully.

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Read DietDoc's comments on "Obesity: A Kaleidoscope of Determinants", a lecture that was presented at a recent workshop on obesity. In this article, she will consider the influence of social determinants, so-called "enablers" or "barriers" to weight loss, and environmental factors.

Social determinants
We are all members of social groups, which define our roles and relationships. These social influences can play an important role in weight control.

Each individual has different roles that are defined by the type of work the person does, the family he or she belongs to, and the community we live in.

Let's say you do sedentary office work and a trolley lady brings you delicious, high-fat snacks three times a day. This is a perfect scenario for weight gain.

If you want to combat the negative effects of the eight hours you spend using practically no energy and the excess kilojoule of the food supplied by the trolley, you will have to make a concerted effort to purchase low-fat foods and bring them along to work. You'll also have to do at least 30 minutes of relatively vigorous exercise every day.

Then there is the social role we play in our families. If you are a mom who has to cook for a large family, chances are you'll be cooking the foods your family likes and not giving attention to reducing fat intake or boosting fibre to ensure your own weight loss.

The secret to this kind of situation is to gradually change the menu for the whole family so that you all eat a balanced, low-fat diet. You are, after all, in charge of the buying and preparation of food, so you can direct what the family will eat.

Then there are our interpersonal relationships, which can have a dramatic effect on weight. Ironically, most married people tend to settle down into a comfortable, lazy rut while the kilos keep piling up. This is a situation where you need to be proactive and make some changes. Change your diet , go to a gym or start doing something to improve your quality of life.

Another social determinant is education. Research has repeatedly shown that people who have little education tend to suffer more from obesity than those who have received some education. If you were not able to obtain a decent education (and millions of South Africans have this problem), then try to find out more about obesity and health and what you can do about it.

You may be able to attend talks at a community clinic or speak to your health visitor about your problem. Don't just give up because you think you lack the skills to make a change in your life. We are all capable of understanding the basic principles of weight loss: eat less and exercise more.

The most difficult social determinant to cope with when you want to lose weight, is probably socioeconomic status. Once again, research shows that financially disadvantaged people tend to suffer from obesity more often than people who have money to buy healthier foods and to do some form of organised exercise.

But then there is the paradox that obesity is practically unknown in some of the poorest communities – not just because everyone is starving, but because these communities eat unprocessed staple foods with a high fibre content, wild fruit and vegetables, sour milk products, legumes, nuts and small quantities of meat.

In addition, these rural communities, which are basically healthy, do a great deal of physical work that keeps them slim and trim.

'Enablers and barriers'
Enablers and barriers are factors that empower people to either make good or bad choices. For example, convenience foods can be regarded as barriers to weight loss because they tempt us to take the easy way out when buying food.

It is so convenient to purchase instant, fat-rich foods, that most modern people don't even know how to prepare an entire meal from non- processed foods.

Enablers would be factors such as access to information about healthy eating and exercise. The internet is a modern factor that enables us to access information about a variety of subjects that can improve our chances of losing weight.

It may help to make a list of enablers and barriers when you set out to lose weight. See what factors are hampering you from achieving your goals and try to replace them with enablers instead.

Environmental factors
There are many environmental factors that can aid or hamper weight loss, for example:

• The home environment can be supportive and conducive to weight loss, or absolutely negative, so that your attempts are doomed before you even start.
• Your shopping environment can also be important. If you have to buy food at a small, understocked shop that does not feature low-fat foods or unprocessed grains, or if you can only buy poor quality fruit and vegetables (if any), then you will struggle to put together the type of diet that will encourage weight loss.
• Accessibility of slimming aids such as health clubs, gyms, and swimming pools may be a deciding factor in your success when it comes to using exercise to aid weight loss.
• The type of neighbourhood you live in will determine if you can, for example, go for safe walks in the fresh air, or if you live in a dangerous, concrete jungle where it is not safe to go out alone.
• The school environment is another environmental factor that can determine weight gain at an early age. If your school does not have facilities for gym or sport, and if the tuck shop is filled with junk food, ask your parents to do something about these problems so that you and your school friends at least stand a chance of not becoming obese children.

It is evident that there are literally hundreds of factors that may influence weight gain or loss. If you have identified some of these factors that play a role in your life, then do something about them.

Don't just shrug your shoulders and say, "I can't change X or Y. I am trapped in this situation". Sit down and figure out what you can do to improve matters and free yourself from being a slave to the factors that cause obesity. – (Dr Ingrid van Heerden, DietDoc)
 

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